By Katherine Kraschel
The loss in Dobbs and the bleak outlook for abortion rights within the federal courts may afford advocates a unique opportunity to fully adopt a reproductive justice framework and apply it to access to fertility care, as other contributors to this symposium have argued.
This article outlines specific strategies for blue states eager to stake a claim in the reproductive justice movement to consider.
By Scott J. Schweikart*
Many medical professionals in the United States today face a personal dilemma over whether to delay (and potentially forego) starting a family in order to fulfill lengthy medical training. In response to these concerns, the American Medical Association (AMA) recently passed a new policy that supports trainee access to assisted reproductive technologies (ART).
By Kimberly Mutcherson
As advocates construct arguments for saving and expanding abortion access, they should also think deeply about what it means to deny or refuse would-be mothers from traditionally disfavored groups the access to assisted reproductive technology.
By Courtney G. Joslin
Increasing numbers of people are forming families through assisted reproduction. Recently, there has been a push to impose new regulations on various aspects of this process. Some of these new laws open up participants to a range of possible penalties — civil, criminal, and/or professional discipline — for past “misconduct.” Other laws seek proactively to regulate the fertility care process. For example, some laws regulate the collection and dissemination of medical and identifying information about gamete providers — that is, sperm and egg donors. Other proposals seek to require gamete providers to agree to the release of their medical records.
It is surely important to assess and evaluate fertility care practices and to consider whether additional regulation is appropriate in this space. Particularly in the post-Dobbs era — an era marked by increasing attacks on reproductive health care (including access to IVF) and on LGBTQ people — it is also important to proceed cautiously and to consider how these proposals may adversely impact reproductive autonomy and family recognition.
By I. Glenn Cohen
It is estimated that roughly one in five hundred U.S. women suffer from Uterine Factor Infertility — they were born without a uterus, they lost their uterus, or their uterus no longer functions. Until very recently, this essentially meant that pregnancy was not an option for these women. Because of uterus transplants, this is beginning to change. Such transplants raise a host of legal and ethical questions, which I will preview in this piece.
By Gerard Letterie and Dov Fox
The overruling of Roe v. Wade has emboldened pro-life lawmakers to confer legal personhood status on early-stage embryos outside of pregnancy as well, including in the context of assisted reproduction. Recognizing embryos as legal persons, it is said, promotes a “culture of life.” And yet treating embryos as persons would actually undermine a promotion of human life, in this critical sense: helping people to have the children they want and are otherwise unable to have.
By Valarie K. Blake and Elizabeth Y. McCuskey
In vitro fertilization (IVF), like most medical care in the U.S., costs far more than most people can afford out-of-pocket: over $12,500 per cycle, with multiple cycles typically required. But, unlike most other expensive medical care, IVF rarely has insurance coverage to defray the cost.
In 2020, only 27% of employers with 500+ employees and 42% of employers with 20,000+ employees covered IVF in their employer plans. Companies like Starbucks and Amazon know this and use it to draw in employees at low (or essentially neutral) wages.
Recent reports reveal women working second shifts for these corporations solely to qualify for employer health benefits that cover infertility treatments. Starbucks, for example, covers IVF for employees who work 240 hours over three months, or roughly 20 hours per week. Frequently, in these low-wage positions, workers earn just enough to pay for their health insurance premiums and sometimes the associated cost-sharing requirements.
How did we get to a place where women must work an “infertility shift” beyond their full-time jobs to access medical care?
By Yvonne Lindgren
In Dobbs v. Jackson Women’s Health, the Supreme Court overruled Roe v. Wade, the constitutional floor that had protected the abortion right for nearly fifty years, and returned the issue of regulating abortion to the states. In the post-Dobbs landscape, thirteen states have banned abortion, either through laws passed after the decision, through trigger laws, or by reviving pre-Roe era abortion bans. As a result of criminalizing abortion, the protective function of medical malpractice law is supplanted by provider and institutional decision-making driven by the imperative to avoid criminal liability and loss of licensure. This essay argues that abortion bans have made all reproductive health care less safe, and that these new pregnancy-related dangers will disproportionately impact assisted reproduction, because those who conceive through assisted reproduction often face a higher risk of complications needing medical intervention, and because women may be reluctant to act as surrogates in light of the heightened risk of pregnancy.
By Naomi Cahn and Sonia Suter
In the aftermath of Dobbs, as barriers to accessing fertility care increase, one area of growing interest is informal (“DIY”) sperm donation, which does not use sperm banks or fertility clinics and thus appears to challenge some of the class and race inequities in access to assisted reproductive technology.
By Judith Daar
In February 2023, a Louisville lawmaker introduced a bill that would prosecute women for criminal homicide for having an abortion. The Kentucky Prenatal Equal Protection Act, introduced by Republican Representative Emily Callaway, extends the state’s criminal abortion law to pregnant women for any termination not linked to a life-threatening condition or spontaneous miscarriage. Declaring, “innocent human life, created in the image of God, should be equally protected under the laws from fertilization to natural death,” the bill elevates the rights of the unborn over any rights held by the pregnant woman to control her reproductive future. Now sanctioned in a post-Dobbs rational basis world, this bill and others like it pose potential roadblocks to other medical interactions with unborn persons, notably in vitro fertilization (IVF) and related assisted reproductive technologies.